Anti-EGFR Reintroduction and Rechallenge in Metastatic Colorectal Cancer (mCRC): A Real-World Analysis

Cancers

Wolf Otto Bechstein¹  Andreas Anton Schnitzbauer¹  Stefan Zeuzem²  Martin S. Schulz²  Oliver Waidmann²  Vera Struck²  Niklas Thomas²  Christine Koch²  Jörg Trojan²  Sebastian Wolf³  Gabriele Husman⁴ 

[1] Department of General and Visceral Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany;Department of Internal Medicine I, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany;Department of Internal Medicine II, University Hospital Frankfurt, Goethe University, 0590 Frankfurt, Germany;Tumor Documentation, University Cancer Center, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany;

关键词: chemorefractory metastatic colorectal cancer;    anti-EGFR therapy;    re-exposure;    rechallenge;    reintroduction;   

DOI  :  10.3390/cancers14071641

来源: DOAJ

【 摘 要 】

Background and Aims: In patients with Rat sarcoma proto-oncogene (RAS) wild-type metastatic colorectal cancer (mCRC), anti-epidermal growth factor receptor (EGFR) antibodies have been established in first- and further therapy lines. Due to limited treatment options upon disease progression, anti-EGFR re-exposure is increasingly employed in real-world oncology. The aim of this study was to assess clinical implementation and utility of anti-EGFR retreatment strategies in real-world mCRC patients. Methods: In this monocentric retrospective study, we included 524 patients with CRC and identified patients who received an anti-EGFR-based treatment as well as anti-EGFR rechallenge (progression on first-line anti-EGFR therapy) or reintroduction (discontinuation due to intolerance/toxicity/other). Results: In total, 143 patients received an anti-EGFR-based first- or second-line treatment, showing a similar overall survival (OS) compared to the non-anti-EGFR treatment group (38.3 vs. 39.6 months, p = 0.88). Thirty-three patients met the inclusion criteria for anti-EGFR re-exposure and were either assigned to rechallenge (n = 21) or reintroduction (n = 12) subgroups. The median FU after re-exposure was 45.8 months. Cetuximab and Panitumumab were used in 21 and 12 patients, respectively, and the main chemotherapy at re-exposure was FOLFIRI in 39.4%. Anti-EGFR re-exposure was associated with a distinct trend towards a better outcome (median OS 56.0 vs. 35.4 months, p = 0.06). In a subgroup comparison, reintroduction was associated with a higher OS and PFS in trend compared to the rechallenge (mOS 66 vs. 52.4, n.s., mPFS 7.33 vs. 3.68 months, n.s.). Conclusions: This retrospective study provides real-world evidence underscoring that anti-EGFR re-exposure strategies might benefit patients independently of the reason for prior discontinuation.

【 授权许可】

Unknown